ethics lecture rant (sensitive topic)

  1. Today our lecture was on ethics and values in nursing care. We were discussing abortions and our teacher was explaining to us that we can refuse to care for a patient if say they are in the hospital because of a serious medical problem due to an abortion. The discussion got a little heated (personally I wouldn't try and refuse to care for anyone unless I felt threatened in some way) but some of the students in my class explained they would never care for a patient who was in the hospital from a problem with an abortion unless obviously no one was available to take over that pt's care. I was surprised a few students felt so strongly about this. I thought a big part of nursing care is to not pass judgement and be as accepting as possible. I realize we're only human but personally I feel that if you have reservations about treating certain pt's because they believe in something you don't...or they have acted in a way that you feel is against your own morals, you're in the wrong profession.

    Anyway...a little fired up from the lecture still and wondering how you guys feel about passing a pt on to another nurse and reasons that would make you refuse care to for someone.

    (no abortion arguments please)

    Ginyer
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  2. 112 Comments

  3. by   UM Review RN
    There are some patients I like better than others, and some patients who have dx's that I excel at dealing with, but I don't think I'd refuse to take care of any patient.

    Every now and then I see patients or family members who have "dollar signs in their eyes" and those I would LOVE to refuse to care for, but the best I have done so far is to just grit my teeth and get through the shift.

    Seems to me that refusing to care for someone means you've played judge and jury to them. I have learned through experience that the judge and jury belong in the courtroom, not in the hospital room.
  4. by   twinbee25
    We had that same discussion in our last semester when we covered the ethics/value topic of nursing. Personally, I would have no problem taking care of someone who was sufferring complications after an abortion. It would be no different that taking care of the overdose that came in through the ER, or the prostitute that is being treated for some sexual disease. They still need care.
    However, I personally feel that I would not work with a patient going through an abortion. To me there is a difference. During or after an abortion...neither is judging the person. Afterwards, they are a patient in need of care. Going through the abortion goes against my own personal values. And though each person is an individual with their own values, each individual has the right to their own values, and everyone needs to respect that. To me its not a matter of judging others, but respecting each others values.
  5. by   RedSox33RN
    I agree, because if you refuse to care for one person for something, where would it stop? Refuse to treat someone with high cholesterol because they eat meat, and you don't? Refuse to treat a drug addict? An alcoholic? Someone that bungee-jumped because YOU would never do it?

    I agree that all of us have our own morals - as we should, it makes us individuals, but there will always be aspects of our job we find distasteful. But I agree with what Angie said - WE are not the ones to play judge and jury. If someone did come in from having a procedure or overdose or whatever - WE were not the ones that were there, we don't know the reasons.

    I don't believe treating the patient means you are accepting what they did was okay. None of us think (I hope!) that drunk driving is okay, yet they are treated all the time - even after they plow into innocent people in a crosswalk.

    I can see why the subject would be touchy, but for me, even with my beliefs, I would never refuse to treat someone.
  6. by   lisamc1RN
    Although I would not participate in an abortion, and would not choose to work in a place where it would be expected that I do so, I wouldn't refuse to care for someone who came from complications of an abortion. There is a difference to me.
  7. by   RedSox33RN
    Quote from twinbee25
    We had that same discussion in our last semester when we covered the ethics/value topic of nursing. Personally, I would have no problem taking care of someone who was sufferring complications after an abortion. It would be no different that taking care of the overdose that came in through the ER, or the prostitute that is being treated for some sexual disease. They still need care.
    However, I personally feel that I would not work with a patient going through an abortion. To me there is a difference. During or after an abortion...neither is judging the person. Afterwards, they are a patient in need of care. Going through the abortion goes against my own personal values. And though each person is an individual with their own values, each individual has the right to their own values, and everyone needs to respect that. To me its not a matter of judging others, but respecting each others values.
    I agree that WORKING with patients in the capacity of assisting with one is a whole different ball game than treating someone after the fact. Very different.
  8. by   Marie_LPN, RN
    I feel that refusing to care for someone because of your own personal opinions and feelings is wrong. Personal opinions and feelings on certain subjects should never interfere with a job, and if there's a possibility that would happen, perhaps that person should avoid an occurance of such, and not take a job where it might happen.
  9. by   crb613
    Quote from Ginyer
    Today our lecture was on ethics and values in nursing care. We were discussing abortions and our teacher was explaining to us that we can refuse to care for a patient if say they are in the hospital because of a serious medical problem due to an abortion. The discussion got a little heated (personally I wouldn't try and refuse to care for anyone unless I felt threatened in some way) but some of the students in my class explained they would never care for a patient who was in the hospital from a problem with an abortion unless obviously no one was available to take over that pt's care. I was surprised a few students felt so strongly about this. I thought a big part of nursing care is to not pass judgement and be as accepting as possible. I realize we're only human but personally I feel that if you have reservations about treating certain pt's because they believe in something you don't...or they have acted in a way that you feel is against your own morals, you're in the wrong profession.

    Anyway...a little fired up from the lecture still and wondering how you guys feel about passing a pt on to another nurse and reasons that would make you refuse care to for someone.

    (no abortion arguments please)

    Ginyer
    I personally don't think I could refuse to care for anyone. I may not agree with their values or lifestyle but I am not their judge. Who knows what you might do if you had been in their situation?? Life is a funny thing you swear you would never do something then it comes knocking at your door & all of a sudden things look a whole lot different when its you or someone you love. It's like the old saying "walk a mile in my shoes".
  10. by   CNM-to-be
    I wouldn't refuse to care for any pt. I may not agree w/ them (heck, I don't agree w/ most conventional medical tx but I digress) but as a nurse my job is to care for the pt w/o passing judgement. That said, I am a Conscientious Objector of infant circumcision. When I'm in practice that's one procedure I will not assist. I will care for the pt. after the surgery but I will not help a doc perform cosmetic surgery on an unconsenting pt. I can understand someone being opposed to abortion (they obviously would not work in a PP clinic) but to refuse care to a woman who had complications from one...seems wrong to me. Kind of like me refusing care to a patient w/ CHF who ate McDonald's his whole life when I am a vegetarian, yk?
  11. by   Ginyer
    [QUOTE=wannaBEanRN]I agree, because if you refuse to care for one person for something, where would it stop? Refuse to treat someone with high cholesterol because they eat meat, and you don't? Refuse to treat a drug addict? An alcoholic? Someone that bungee-jumped because YOU would never do it?

    Exactly...where would it stop? We are going to come across pt's all the time who have completely different lifestyles than our own. We won't know the whole story or the entire truth of the situation they are in which is why we couldn't appropriately pass any type of judgement on them. Like I said I was just really surprised that my classmates were so quick to say they would automatically refuse to care for this group of pt's. I sure hope they aren't planning on working in the ER.



    A student in my class works on the telemetry floor as a pca. She was telling us about a pt that comes in almost every month who supposedly is sexually harassing his female nurses. He'll grab their butt, grab their breasts, talk dirty, exposes himself, and sometimes when they lean over him for something he'll grab the front of their scrub top and pull it down and look down their top. They get male nurses for him when they can but they're rarely available on that floor. I'm not aware of what hospital policy is on this type of stuff. This situation is a different can of worms but we're talking about what would affect our care for a pt. I have no idea how this would affect my care for this pt. Just wondering what yall thought about it.

    Ginyer
    Last edit by Ginyer on Feb 5, '05 : Reason: typo
  12. by   HyperRNRachel
    From what I remember, you can refuse to care for a patient having an abortion but you cannot refuse care if they are their from complications of the abortion. Abortion and life threatening danger to the nurse is the only time you can refuse care to a patient.
  13. by   VivaLasViejas
    I have never refused to care for a patient, although I came close to doing so a couple of years ago when we had a 'skinhead' come in for an appy with all sorts of racist tattoos on his arms, his chest, even his neck. He was a nasty piece of work who refused to be cared for by anyone who wasn't female and white. He wouldn't even allow the CNA, who was Filipina, to take his vital signs.........Naturally, it was my rotten luck to be assigned to him, and I was half-tempted to address him in Spanish just to see how he would react. :stone

    What made me even angrier was, he was all friendly and polite with me right after he'd demanded "a WHITE nurse, g**dammit!" How I wanted to tell him, right then and there, what I thought of him and his views! :angryfire I've got some Cherokee and Hispanic background, plus I'm Catholic, so I could've really let him have it........but of course, that would have been unprofessional, so I contained myself and got through the day as well as I could. :stone
  14. by   fergus51
    Ginyer, I used to feel the way you do. Then I took a job in an area of nursing that deals with a lot of ethical grey areas. I have asked to be assigned another patient once in my career because what we were doing to that child was so horrific to me that I knew I couldn't provide the best care to the family. I see no value in forcing nurses to care for those patients. It harms the nurse and the patient. Personal feelings probably shouldn't interfere with work, but I'm not a robot. I'm not the perfect nurse. I try to do my best every shift, but some things are just too much sometimes and I'm lucky that I have supportive coworkers who are understanding of that.

    Some things that might make you understand where I'm coming from: Would you look after an infant that we were allowing to dehydrate to death and not give it any fluids? Would you be willing to code a child who has a terminal condition over and over (see a code yet? It isn't gentle)? These are both situations I've been faced with as a nurse. One I could deal with, one I couldn't. I hope you can understand, it isn't about judging others, it's about being ablt to live with myself.

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